Project Summary Nebraska (NE) PRAMS has provided quality and comprehensive data on maternal and child health risks and behaviors since 1999, and has become a major participant in the state's strengthened public health system. PRAMS complements the vital records database adding nuances that only self-reported data can do. On the surface, Nebraska appears to have very good pregnancy outcomes. However, the large percentage (77.5%) of White births drives state averages, and masks considerable disparity when outcomes are examined by maternal race and ethnicity. The Lifespan Health Services Unit (LHSU) is home not only to MCH Epidemiology and NE PRAMS, but also to the rest of the MCH-related programs. These programs have been among the strongest supporters of PRAMS and users of the data; being housed in the same unit makes PRAMS data and staff easily accessible to those programs. This has resulted in PRAMS data being integrated into the official MCH and the Reproductive Health priorities. The state's birth certificate data provides valuable information on women during their pregnancy and delivery and on the newborn. However, these data predominantly address demographic and medical conditions. High-quality, Nebraska- specific, population-level data are scarce on key factors such as behavioral risks, and mothers' experiences with and perceptions of healthcare. Thus, the birth certificate registry is limited in its ability to provide detailed information for program planning and evaluation. Birth certificate data are complemented for some populations by data available from specific programs. However, these data do not reflect the state as a whole. NE PRAMS is currently the only readily-accessible source for population-level data on important issues such as pregnancy intendedness, reasons for patterns of prenatal care use, nutritional status of the mother, preconception health, and for postnatal behaviors such as depression, infant sleep position, breastfeeding or maternal morbidity. Importantly, PRAMS data allow valid statements to be made about ?new Nebraska mothers? rather than only for selected populations or program recipients. NE PRAMS stratifies by race/ethnicity and will continue to provide data to plan strategies to address these issues and for evaluation.